The CommonHealth

Dr. Dylan George, Director of the CDC Center for Forecasting and Outbreak Analytics (CFA), walks us through the CFA’s status, almost two years after its launch. Though still a startup, CFA has modeled multiple outbreaks, including Omicron, Mpox, and now the respiratory virus season (Covid, RSV, flu). Its clients? The White House and executive agencies, and increasingly, state, local and territorial officials. Its products? October 24, it issued its Respiratory Season Outlook. On November 8, CFA launches its $262 million/five year investment in a National Network for Outbreak Response and Disease Modelling, encompassing thirteen key university and private sector expert data partners across the country. Critical to CFA’s success will be building new communications capabilities to cut through noise and distrust and build trust and confidence.

Dr. Suerie Moon, Co-Director of the Global Health Center and Professor of Practice, International Relations and Political Science, walks us through the status of the pandemic accord negotiations (underway for two years), the recently released new draft, what lies ahead in the next round of deliberations, and how that diplomatic process relates to parallel negotiations underway over reform of the International Health Regulations (IHR). The draft treaty speaks to four core issue sets: One Health; access and benefits sharing (ABR); countermeasures (including intellectual property, R&D, technology transfer); and financing (including “common but differentiated responsibilities”). Today, there is “lots of space to bridge.” While the negotiations are not likely to cross the finish line in May 2024, that does not necessarily signal failure. “More time is needed.” A breakthrough in a few areas by May 2024 could sustain progress. The U.S. negotiating role remains “incredibly important.” Remarkably, in these polarized and difficult geopolitical times, these dual talks have not yet been torn apart. The focus remains on health, with a newfound belief in equity as a guiding norm.

Len Rubenstein shares his trenchant, mixed reflections from a September visit to Ukraine, specifically the multiple burdens that the war imposes on Ukrainian society. Ukrainian morale and resolve remain strong, though gaps persist in medical rehabilitation services, including prostheses for soldiers who have lost limbs. 500 Ukrainian military medics and reportedly 20,000 Ukrainian civilians are currently held in Russian prisons, in violation of international law. Almost everyone points to the high level of mental health disorders. The war itself has changed: Russia has created the world’s largest mine fields.

Dr. Eric Goosby walks us through the Lancet Commission report on tuberculosis—which he chaired—that was issued immediately prior to the September 22 UN High Level Meeting on TB. The environment for progress remains very tough—shortfalls in political will, prioritization, finances, and investment by industry. But there are recent, promising gains in diagnostics and therapies. And a promising vaccine, M72, is now in advanced trials. That could be a breakthrough in the future. GSK, in partnership with Gates Foundation and Wellcome Trust, are investing $550m in fields trials across Africa and Southeast Asia. What was the significance of the High-Level Meeting? It generated a detailed agenda to which national governments should be held to account. Eric closes with personal reflections on the passing of Senator Dianne Feinstein.

Kate Dodson, UN Foundation and Nellie Bristol, CSIS Senior Associate, survey the outcomes of the UN General Assembly during the third week of September, with a special focus on SDGs and the health High Level Meetings (HLMs on pandemic preparedness and response, TB, Universal Health Coverage). Big cross-cutting themes emerged–gaps in finance, equity, health workforce, access, R&D, and intellectual property. Results were decidedly mixed: “process got in the way of ambition.” Overload carries a price, as do acute geopolitical tensions. Senior U.S. officials “showed up” at every point. President Biden spoke early about the SDGs–before Ukraine. What happened in New York may help nudge the negotiators in Geneva working on the pandemic accord. The results in New York may argue for greater precision in the 2024 High Level Meeting on Anti-Microbial Resistance (AMR). One resounding signal–members of the African Union were exceptional in their engagement. 

In this episode of The CommonHealth, we share the audio of a September 11 conversation among several different CSIS scholars on the question of whether the climate shocks of this summer were simply a continuation of underlying trends – an exclamation point – or a thunderclap signaling the arrival of a new moment. Hear from economist Stephanie Segal, climate scientist Joseph Majkut, water and food security expert Caitlin Welsh, and CommonHealth’s co-host, J. Stephen Morrison. 

Dr. Scott Dowell, the Bill & Melinda Gates Foundation, unpacks the foundation’s $2 billion in investments during the three-year acute phase of the pandemic. Some of the most impactful were in surveillance and modeling. The Seattle Flu Study, which predated the pandemic, was fortuitous in what it taught us. Bill Gates’ 2022 book, How to Prevent a Pandemic, introduced the concept of ‘the GERM team’ which has now evolved into the Global Health Emergency Corps, led by the World Health Organization. What are the GHEC’s component elements, and how will it be launched? The foundation continues to engage intensely with the Chinese: what is to be gained? What lessons have emerged from China’s experience? Current foundation R&D priorities include scaled diagnostics, early start of broad spectrum anti-virals, and vaccines in 100 days. On surveillance, priorities are sequencing and wastewater testing. End of the day, “I am optimistic.”

Dr. Celine Gounder walks us through what to expect as the fall respiratory virus season unfolds—the ‘tripledemic’ of Covid, flu, and RSV (respiratory syncytial virus). Promising new vaccines are becoming available amid confusion, disinformation, and burnout of the health workforce. Competent communications remain essential, though “most people do not believe the lies or the truth.” The elderly and the immunocompromised stand to gain the most from these vaccine opportunities. In the post-Covid moment, ‘hyperlocal’ leaders and the business sector matter enormously in shaping the response. 

In this episode of The CommonHealth, Andrew Schwartz engages Michaela Simoneau and co-host J. Stephen Morrison on their newly published analysis of the post-Covid moment, “The Worst is Over—Now What?” How do we define this moment we have entered, and what are the factors that lead inexorably towards pessimism? Inversely, what is the argument for a positive, sober realism? Optimism rests on pursuing five pathways for progress: rebuild trust, sustain bipartisan legislative achievements, operationalize new security doctrines, accelerate new technologies, and elevate U.S. health diplomacy. 

According to the recent report from the WHO/UNICEF Joint Monitoring Program for Water Supply, Sanitation and Hygiene, coverage of safely managed water and sanitation supplies has improved globally since 2000, but the world is not on track to meet the Sustainable Development Goal targets related to universal coverage. Placing a special emphasis on gender, the JMP report notes that inadequate access to water and sanitation, as well as hygiene services, affects men and women in significant, but different, ways. In this episode, Sera Young, Associate Professor of Anthropology and Global Health at Northwestern University and senior associate with the CSIS Food and Water Security Program, discusses the relationship between gender and water, sanitation and hygiene (WASH) and explains why it’s important to gather data, not just about men’s and women’s access to water and sanitation infrastructure but also about how individuals’ experience of water insecurity affects their physical and mental health. Armed with data about access and impacts, communities can raise awareness, demand policy change, and oversee improvements in the WASH sector.